Older persons are notoriously unwilling to use hearing aids. But a new study conducted by researchers at Columbia University Medical Center (CUMC) found that older adults who used a hearing aid performed significantly better on cognitive tests than those who did not use a hearing aid, despite having poorer hearing. The study was published online in the American Journal of Geriatric Psychiatry. The researchers also found that cognitive function was directly related to hearing ability in participants who did not use a hearing aid. More than half of adults over age 75 have hearing loss, yet less than 15 percent of the hearing impaired use a hearing aid device. Previous studies have shown that the hearing-impaired elderly have a higher incidence of fall- and accident-related death, social isolation, and dementia than those without hearing loss. Studies have also demonstrated that hearing aid use can improve the social, functional, and emotional consequences of hearing loss. The study included 100 adults with hearing loss between the ages of 80 and 99. Hearing aid users, who had worse hearing than non-users, performed significantly (1.9 points) better on tests of cognitive and motor functioning. Among non-users, participants with more hearing loss also had lower MMSE scores than those with greater hearing levels.

For the article from EurekAlert, click here.

As cities experience a demographic shift, the need for age-friendly design is becoming ever more critical. From almshouses to driverless cars, the future of urban housing and mobility may just be shaped for and by the elderly. As we age, our housing, transport and social needs change. By preparing for this, policymakers, town planners and architects can make it more likely that older populations can still lead fulfilling lives. The global engineering firm Arup has looked at how authorities are responding to this demographic shift. Stefano Recalcati, project leader behind the firm’s report Shaping Ageing Cities, explains that cities must adjust if older people are to maintain quality of life: “It’s important to be conscious of the ageing trend. It is a huge challenge for world cities – they will need to change, to make sure older people continue to play an active role in the community and don’t become isolated. Isolation has a negative impact on health so tackling that is really important.” “Small innovations can make a difference,” Recalcati adds. “Older people are less likely to drive, favoring public transport and walking. The average person over 65 manages a walking speed of 3km [1.9 miles] / hour. At 80 that goes down to 2km [1.2 miles]/hour, compared with the average for a working age person of 4.8km [2.9 miles]/hour. Reducing the distance between transport stops, shops, benches, trees for shade, public toilets and improving pavements and allowing more time to cross the road all encourage older people to go out.” In the UK, the government has just announced the building of 10 new towns designed to address ageing and health issues such as obesity. As well as encouraging more active lifestyles, the designs could include wider pavements, few trip hazards and moving LCD signs, making the streets easier to navigate for people with dementia and other age-related conditions.

For the article from The Guardian, click here.

Dr. Caleb Alexander knows how easily older people can fall into so-called polypharmacy. Perhaps a patient, like most seniors, sees several specialists who write or renew prescriptions.

“A cardiologist puts someone on good, evidence-based medications for his heart,” said Dr. Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. “An endocrinologist does the same for his bones.” And let’s say the patient, like many older adults, also uses an over-the-counter reflux drug and takes a daily aspirin or a zinc supplement and fish oil capsules. Geriatricians and researchers have warned for years about the potential hazards of polypharmacy, usually defined as taking five or more drugs concurrently. Yet it continues to rise in all age groups, reaching disturbingly high levels among older adults. Tracking prescription drug use from 1999 to 2012 through a large national survey, Harvard researchers reported in November that 39 percent of those over age 65 now use five or more medications — a 70 percent increase in polypharmacy over 12 years. Lots of factors probably contributed, including the introduction of Medicare Part D drug coverage in 2006 and treatment guidelines that (controversially) call for greater use of statins. But older people don’t take just prescription drugs. An article published in JAMA Internal Medicine, using a longitudinal national survey of people 62 to 85, may have revealed the fuller picture. More than a third were taking at least five prescription medications, and almost two-thirds were using dietary supplements, including herbs and vitamins. Nearly 40 percent took over-the-counter drugs.

For the article from the New York Times, click here.

The Obama administration tightened rules for private insurance plans that administer most Medicaid benefits for the poor, limiting profits, easing enrollment and requiring minimum levels of participating doctors. For consumers the most visible change may eventually be quality ratings intended to reflect Medicaid plans’ health results and customer experiences. The administration agreed to move slowly on such a sensitive industry issue, saying it would develop the scores over several years. But the sweeping regulation, the biggest for Medicaid managed care in a decade, changes many aspects of how UnitedHealthcare, Aetna and other large contractors who administer care for some of the most vulnerable patients do business.

For the article from Kaiser Health News, click here.

A staggering share of veterans who served in Iraq and Afghanistan have been returning home with mental illnesses brought on by their time overseas. But as hundreds of thousands struggle with post-traumatic stress disorder, many are going without the help they need, which is prompting several states to step in. State officials say they are trying to bridge what they see as gaps in services provided by the U.S. Department of Veteran Affairs, whose medical centers have been plagued by mismanagement, often face lengthy backlogs and can be located far from rural communities. If veterans with PTSD aren’t treated while their wounds are still raw, it will end up costing not only the veterans and their families, but society, according to state lawmakers and mental health workers. Veterans with PTSD are more likely to be depressed, drink heavily or use drugs, and many have trouble working and maintaining relationships — problems that cost billions of dollars in lost productivity. Starting this year, Texas will give money to nonprofits and private programs that provide treatment to veterans with PTSD and their families. New Hampshire has been training community mental health staff since last summer on how to find veterans and treat their PTSD. And New York is expanding a program that connects service members and veterans with mental health needs in small settings or in activities such as yoga and tai chi. Although state and local governments have long relied on the VA, states have an obligation to veterans, and they need to do more, said Kathryn Power, a regional administrator for the Substance Abuse and Mental Health Services Administration. The agency encourages local governments at a minimum to train mental health center staff about military culture, and make sure they know how to help veterans and their families.

For the article from Pew Charitable Trusts, click here.