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Affiliated with the Rhode Island AFL-CIO “Fighting for the future of our members.” “NOW, more than ever!!!” Publication 2018 Issue 37 Published in house by the RI ARA

September 16, 2018 E-Newsletter

All Rights Reserved RI ARA 2018©

AP FACT CHECK: Trump's not-so-strong Medicare, economy myths Eager to dismiss his critics, President Donald Trump is fabricating the circumstances regarding jobs, the economy, and the social safety net. He insists that Social Security and Medicare are becoming stronger under his watch when the most recent government report shows the financial condition of both programs worsening. On the economy, his claims of spurring the strongest U.S. growth ever fall way short. The statements were among varied misrepresentations from the White House and in hearings for his Supreme Court nominee, coming in a remarkable week after an anonymous senior official went public about an effort within the administration to thwart his agenda. Trump also faces the special counsel's continuing Russia investigation, fewer than 60 days before November's midterm elections. A look at the rhetoric and how it compares with reality:

MEDICARE AND SOCIAL SECURITY TRUMP: "We're saving Social Security. The Democrats will destroy Social Security. We're saving Medicare. The Democrats want to destroy Medicare. ...We will keep it going. We're making it stronger. We're making Social Security stronger." — remarks Wednesday. TRUMP, pr omoting Montana Republican Matt Rosendale's Senate campaign: "I'm going to protect your Social Security. We're going to take care of your Social Security. Matt Rosendale is going to make sure we're not touching your Social Security and your Medicare is only going one way. That's stronger." — Montana rally Thursday. THE FACTS: Trump hasn't made Medicare and Social Security stronger. The government's annual

trustees reports on the programs released in June shows the financial condition of both worsening significantly since last year. The projected insolvency for Social Security stayed unchanged — in 2034 — but Medicare's moved three years closer, to 2026. Both programs also will start tapping their reserves this year, meaning that income from payroll taxes and interest earned by the Social Security and Medicare trust funds will no longer cover costs. That threshold was still a few years away in last year's report. As a result, Social Security and Medicare will need a $416 billion transfer from the government's general revenues this year, when the federal deficit is already rising. Last year's Republican tax bill, which cut taxes on Social Security benefits, helped exacerbate the shortfall. So did

the Trump-supported repeal of the individual mandate in socalled Obamacare. The repeal promises to increase the number of people without health insurance and therefore Medicare payments for uncompensated medical care. Trump campaigned on a promise not to cut Social Security or Medicare, but he hasn't offered a blueprint for either program. Democrats want to expand the social safety net by spending more. Treasury Secretary Steven Mnuchin has argued that tax cuts, rolling back regulations and better trade agreements could boost economic growth and help stabilize Medicare and Social Security. But nonpartisan government experts who produced the annual Social Security assessment didn't seem to accept that, forecasting "sustained moderate economic growth."...Read More

Administration Challenge to ACA’s Pre-Existing Condition Protections at Odds With Public Opinion A federal court is considering a challenge to the Affordable Care Act’s (ACA) protections for people with pre-existing conditions that a number of state attorneys general have filed and the Trump Administration has chosen not to defend. But the public—including most Republicans—want those protections preserved. A recent Kaiser Family Foundation tracking poll finds that 72-75% of Americans say that it is “very important” to keep provisions that stop

insurance companies from denying coverage or charging more based on medical history. Over 55% of Republicans said it was very important to do so. It is also the 90thtime that the foundation has asked about the public’s opinion of the ACA generally, and this month 50% view the law favorably, while 40% view it unfavorably. The report also finds that more than 40% of Americans are “very worried” that they or a family member will lose

coverage or have to pay more if the court invalidates the ACA protections, and that nearly 60% are “very concerned” about increases in healthcare costs and that those costs top their own affordability concerns. Twothirds of people said that they are at least “somewhat” worried about affording an unexpected medical bill, and about half say the same about deductibles and drug costs—higher than the number worried about

transportation, utility or rent/mortgage payments. The poll also found that health care is among the top issues voters wanted to hear candidates discuss ahead of the November midterm elections. Nearly a third of people said that health care is the most important issue they will consider in making their voting decisions, and they most want to discuss health care costs. Read Medicare Rights take on the court case.

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The High Cost Of Hope: When The Parallel Interests Of Pharma And Families Collide A desperate but determined group of parents raised millions through golf tournaments and cocktail parties to support research for drugs to fight cystinosis, a rare, fatal childhood disease. They were ecstatic when a pill called Procysbi was approved in 2013. The twice-a-day medicine was a breakthrough because it supplanted an existing drug with debilitating side effects that had to be taken every six hours around the clock — a missed dose could permanently damage a child’s kidneys. But the families’ elation dimmed when Raptor Pharmaceutical, which acquired

the marketing rights and financed clinical trials for Procysbi, priced the drug: more than $300,000 a year for some patients. “When I heard the number, I was like, holy … that’s incredible!” said Kevin Partington, the father of twins with cystinosis. “The first thought was, how do we pay for it and get this approved through insurance?” Manufacturers selling precious, lifesaving medicines and patients share an uneasy alliance. They need each other

but have clashing priorities, especially when it comes to drugs treating rare diseases such as cystinosis. Cystinosis families say they are deeply grateful for Procysbi. The medicine would not be on the market without Raptor — which performed clinical trials — and Horizon Pharma, which acquired the rights two years ago, they acknowledge. But they also feel they’ve been used. What began as a desperate search for lifeextending medicine, cystinosis parents say, has become a story

of corporations profiteering off their children. What’s more, they say, even as they have tried to keep the companies at arm’s length, Horizon and Raptor have breached sensitive boundaries around their tightknit community to increase sales. “I feel like it’s all about the bottom line,” said Denice Flerchinger, who has a daughter with cystinosis and helped raised some of the first research funds for the drug. “I don’t think any of us thought they could do this and get away with it.”….Read More

Insulin’s Steep Price Leads To Deadly Rationing Diabetic ketoacidosis is a terrible way to die. It’s what happens when you don’t have enough insulin. Your blood sugar gets so high that your blood becomes highly acidic, your cells dehydrate, and your body stops functioning. Nicole Smith-Holt lost her son to diabetic ketoacidosis, three days before his payday, because he couldn’t afford his insulin. “It shouldn’t have happened,” Smith-Holt said, looking down at her son’s death certificate on her dining room table in Richfield, Minn. “That cause of death of diabetic ketoacidosis should have never happened.” The price of insulin in the U.S. has more than doubled since 2012 alone. That’s put the lifesaving hormone out of reach for some people with diabetes, like Smith-Holt’s son Alec Raeshawn Smith. It has left others scrambling for solutions to afford the one thing they need to live. I’m one of those scrambling. Not Enough Time Most people’s bodies create insulin, which regulates the

amount of sugar in the blood. The roughly 1.25 million of us in the U.S. with Type 1 diabetes have to buy insulin at a pharmacy because our pancreases stopped producing it. My first vial of insulin cost $24.56 in 2011, after insurance. Seven years later, I pay more than $80. That’s nothing compared with what Alec was up against when he turned 26 and aged off his mother’s insurance plan. Smith-Holt said she and Alec started reviewing his options in February 2017, three months before his birthday on May 20. Alec’s pharmacist told him his diabetes supplies would cost $1,300 a month without insurance — most of that for insulin. His options with insurance weren’t much better. Alec’s yearly salary as a restaurant manager was about $35,000. Too high to qualify for Medicaid, and, Smith-Holt said, too high to qualify for significant subsidies in

Minnesota’s Affordable Care Act insurance marketplace. The plan they found had a $450 premium each month and an annual deductible of $7,600. “At first he didn’t realize what a deductible was,” Smith-Holt said. She said Alec figured he could pick up a part-time job to help cover the $450 per month. Then Smith-Holt explained to her son what a deductible was. “You have to pay the $7,600 out-of-pocket before your insurance is even going to kick in,” she recalled telling him. Alec decided going uninsured would be more manageable. Although there might have been cheaper alternatives for his insulin supply that Alec could have worked out with his doctor, he never made it that far. He died less than one month after going off of his mother’s insurance. His family thinks he was rationing his insulin — using less than he needed — to try to make it last until he could

afford to buy more. He died alone in his apartment three days before payday. The insulin pen he used to give himself shots was empty. “It’s just not even enough time to really test whether [going without insurance] was working or not,” Smith-Holt said. A Miracle Discovery Insulin is an unlikely symbol of America’s problem with rising prescription costs. Before the early 1920s, Type 1 diabetes was a death sentence for patients. Then researchers at the University of Toronto — notably Dr. Frederick Banting, Charles Best and J.J.R. Macleod — discovered a method of extracting and purifying insulin that could be used to treat the condition. Banting and Macleod were awarded a Nobel Prize for the discovery in 1923. For patients, it was nothing short of a miracle. The patent for the discovery was sold to the University of Toronto for only $1 so that lifesaving insulin would be available to everyone who needed it….Read More

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Tell CMS Not to Create More Burdens for People with Medicare through this “Fix” The Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees the Medicare program, is seeking comments on a proposed rule that would completely restructure how Medicare providers are paid. This new proposal could have significant, negative implications for people with Medicare. We encourage those who are interested in Medicare policy to let CMS know about your concerns before the comment period closes on Monday, September 10. Read below to learn what’s in the proposal and what you can do to respond before the deadline! Currently, Medicare providers are paid through a complicated reporting process that involves a number of billing codes—where providers claim a certain level of

reimbursement based, in part, on the complexity of the care they give. For example, providers are paid a smaller amount for simpler, shorter visits, and a larger amount for visits where more issues are handled and at a greater depth. Providers have raised concerns about this payment system, noting that it is difficult for them to know what level of visit they should claim and that the documentation is both time consuming in nature and prone to inaccuracies. To purportedly ease the administrative burden on providers, CMS has proposed a complete overhaul of this process. At Medicare Rights, we are pleased that CMS is tackling this longstanding issue, but the

details of the proposed solution are worse than the problem itself. Instead of clarifying how the codes are to be used, CMS plans to collapse the codes together and pay only a flat fee per office visit—no matter how major or minor the visit is. This creates a situation where a 5-minute check in would be paid the same as an indepth exploration of several significant conditions. We fear such a system would incentivize providers to shorten visits and, in some cases, to schedule more visits to cover what could likely have been covered in a single, longer visit. Shorter, more frequent visits would mean more cost sharing for patients, and more burden in traveling to and from

appointments. People in rural areas or those who rely on family or other caregivers would be especially harmed. In the worst cases, it may drive some providers out of the Medicare program entirely, reducing people’s access to care. This would be particularly devastating for beneficiaries who rely on certain specialty providers and those who live in rural or underserved areas. We support efforts to clarify the reimbursement codes for providers, but this is not the way to proceed. At the very least, CMS should run small tests on their proposals to ensure that it would not harm beneficiary access to care or increase financial or physical burdens. Comments were due by September 10, 2018. However, I thought it is good information.

IRS Advises Many Americans Who Will Pay More in Taxes After GOP Tax Scam to Adjust Withholding Congressional auditors from the Government Accountability Office (GAO) have discovered that about 30 million taxpayers will have to pay extra taxes next spring as a result of employers under-withholding taxes from paychecks. The IRS advises taxpayers who support dependents to check their withholding now. The necessary IRS forms and Tax Calculator can be be found here. Many employers operated under government issued tables keyed to the tax scam passed last December, but employers

estimated lower taxes based on inaccurate tables and promises by the administration. While the new tax scam is not solely to blame for the large number of employees affected, under-withholding due to the flawed tables has directly impacted at least three million workers. Under-reporting taxes in paychecks makes the take-home pay seem higher, but workers are then hit with increased tax payments during filing season. Many workers were supposed to

see increased wages and lower taxes as a result of the tax law, but instead only 4% of workers have experienced a wage increase or a bonus. Meanwhile, large corporations are experiencing increased profits and CEO's are experiencing salaries 312 times higher than the average worker. The audit came at the request of senior Democratic Senators who were concerned with the withholding tables earlier this year. At the time, Treasury

Secretary Steve Mnuchin called the notion "ridiculous." "The GAO report highlights the true scam that the tax law has brought upon workers in our country," said President Roach. "The GOP's broken promises deceived workers into thinking that they would reap the benefits of tax cuts. Instead, we are experiencing stagnant wages while the richest corporations and CEO's continue to get richer. Taking the IRS’s withholding advice will at least minimize the damage."

Pharma chief defends 400% drug price rise as a ‘moral requirement’ A pharma executive has defended his decision to raise the price of an antibiotic mixture to more than $2,000 a bottle, arguing there was a “moral requirement to sell the product at the highest price”. Last month, Nostrum Laboratories, a small Missour i

-based drugmaker, more that was first marketed than quadrupled the price in 1953, which appears of a bottle of on the World Health nitrofurantoin from Organization’s list of $474.75 to $2,392, essential medicines. It according to Elsevier’s Gold comes in a tablet form as well as Standard drug database. a liquid version that Nostrum Nitrofurantoin is an antibiotic makes. used to treat bladder infections

In an interview, Nirmal Mulye, Nostrum chief executive, said he had priced the product according to market dynamics, adding: “I think it is a moral requirement to make money when you can . . . to sell the product for the highest price.” ...Read More

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The Remedy For Surprise Medical Bills May Lie In Stitching Up Federal Law When Drew Calver had a heart attack last year, his health plan paid nearly $56,000 for the 44-year-old’s four-day emergency hospital stay at St. David’s Medical Center in Austin, Texas, a hospital that was not in his insurance network. But the hospital charged Calver another $109,000. That sum — a socalled balance bill — was the difference between what the hospital and his insurer thought his care was worth. Though in-network hospitals must accept pre-contracted rates from health plans, out-ofnetwork hospitals can try to bill as they like. Calver’s bill eventually was reduced to $332 after Kaiser Health News and NPR published a story about

it last month. Yet his experience shines a light on an unintended consequence of a wide-ranging federal law, which potentially blindsides millions of consumers. The federal law — called ERISA, for the Employee Retirement Income Security Act of 1974 — regulates company and union health plans that are “self-funded,” like Calver’s. That means they pay claims out of their own funds, even though they may be administered by a major insurer such as Cigna or Aetna. And while states increasingly pass laws to protect patients from balance bills as more hospitals and doctors go after patients to collect, ERISA

law does not prohibit balance billing. Although Texas is one of nearly two dozen states that provide consumers with some degree of protection against surprise balance bills, those state laws don’t apply to self-funded plans. It’s a fairly common problem. About 60 percent of workers who get coverage through their job have selfinsured plans, and 18 percent of people with coverage through a large employer who were admitted to the hospital in 2016 received at least one bill from an out-of-network provider, according to an analysis by the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program

of the foundation.) Health researchers and advocates have identified a number of potential solutions that could tackle the problem at the federal or state level. The courts are another option. Yet whether these efforts are politically feasible when health care is in play as a partisan football is another matter. Polarized views on appropriate reimbursement levels for medical services “limit stakeholders at both the federal and state level from making progress,” said Kevin Lucia, a research professor at Georgetown’s Center on Health Insurance Reforms, who has analyzed state laws that restrict balance billing….Read More

A stock-market bear signal is at a more-than-4-decade high, says Goldman A gauge of bullish and bearish momentum in the U.S. stock market is ringing alarms for strategists at Goldman Sachs. The investment bank’s so-called bull-bear indicator, which examines five market factors, indicates that the likelihood of a bear market occurring is at its highest point since around the mid-1970s (see chart on right). Goldman analysts led by Peter Oppenheimer, chief global equities strategist, said an unusual period for Wall Street, characterized by loose monetary policy and a recent spate of fiscal stimulus has resulted in an uncannily bullish cycle for markets that is likely to come to a screeching halt. ...Read More

Group Raises Nearly $1M for Susan Collins’ Nonexistent Opponent If She Votes to Confirm Brett Kavanaugh With the conclusion of three days of intense—even showboat-y—questioning of Supreme Court nominee Brett Kavanaugh by members of the Senate Judiciary Committee, public attention has shifted to one of the elected officials who actually holds the fate of Kavanaugh’s confirmation: Sen. Susan Collins of Maine. One group hopes to influence Collins’ vote with a small fortune in campaign

contributions to her next political opponent—whoever they may be. Two political action committees based in Collins’ home state, the Maine People’s Alliance and Mainers for Accountable Leadership, have joined forces with progressive activist Ady Barkan to crowdfund in support of the senator’s Democratic opponent in 2020, despite the Maine

Democratic primary not being scheduled for roughly 21 months. As of this writing, the campaign has raised a stunning $900,801, with every dollar earmarked for Collins’ eventual Democratic opponent if Collins fails, in the words of the campaign, “to stand up for the people of Maine and for Americans across the country” by voting against Kavanaugh’s

confirmation. By comparison, Collins’ Democratic opponent raised a mere $2.3 million during Maine’s most recent Senate campaign, making the nearly $1 million fund a jackpot for an ambitious Maine Democrat hoping to unseat the four-term senator. (Collins raised $6.2 million, and won re-election with nearly 70 percent of the vote.)...Read More

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OxyContin maker gets patent to treat opioid addiction Purdue Pharma, the maker of OxyContin, has received a patent designed to treat opioid addiction. The patent, first reported by The Financial Times, is for a new and faster-acting form of buprenorphine. Buprenorphine controls drug cravings and is often given as a substitute to people hooked on heroin or opioid painkillers such as OxyContin. Buprenorphine is currently prescribed in tablets or fastdissolving strips. The patent is for a "wafer" of buprenorphine that would dissolve in just a few seconds. "While opioids have always been known to be useful in pain treatment, they also display an addictive potential," the patent states. "Thus, if opioids are taken by healthy human subjects

with a drug-seeking behaviour they may lead to psychological as well as physical dependence." TV anchor shares personal story of loss to fight stigma of opioid addiction Purdue Pharma is the subject of many lawsuits for allegedly fueling the opioid epidemic. The Sackler family, which controls Purdue, was personally named in a lawsuit in June in which the Massachusetts attorney general accused them of a "deadly, deceptive scheme to sell opioids." The company, and the Sackler family, deny those allegations. Richard Sackler, who sits on the company's board, is listed as one of the inventors on the patent.

Use of OxyContin, invented in 1995, was fueled by an aggressive marketing campaign that led to it becoming the most widely prescribed opioid. Though prescriptions for the drug started to decline in 2010, it still garnered more than $2 billion in sales in 2015, according to the Los Angeles Times. Purdue pleaded guilty in 2007 to a felony charge of misleading regulators about OxyContin's potential for abuse and paid a fine of $600 million, although a whistleblower says the company continued its deceptive sales tactics after that date. In June of this year, the company laid off its entire sales team. Earlier this week, the company donated $3.4 million to a

nonprofit drug developer working on an over-the-counter version of naloxone, a nasal spray used to treat opioid overdoses that retails for about $140 per dose. Opioid maker Purdue Pharma backs off aggressive marketing Purdue will not receive royalties from sales of the naloxone treatment, which is being developed by Harm Reduction Therapeuticals, the company said. About 48,000 people died from opioid overdoses last year, according to the CDC. Since 2013, a total of more than 170,000 people have died from overdosing on opioids, including heroin. A Purdue spokesman declined to answer questions about the patent, calling the FT report "a story built on speculation."

Judge urges FDA to expedite graphic label requirements A federal judge in Boston has ordered the Food and Drug Administration to expedite writing a rule that would mandate graphic warnings on cigarette packages and advertisements. Judge Indira Talwani said Wednesday that the FDA is not working quickly enough to issue new mandates after past graphic warnings were thwarted in 2012

following challenges from tobacco companies, according to the Associated Press. Talwani told the FDA that it has until Sept. 26 to provide a schedule for creating a finalized graphic warning. She wrote the FDA "unlawfully withheld" or "unreasonably delayed" the

dissemination of graphic warnings, according to The National Law Journal. The ruling is part of a case brought by multiple public health and medical groups in 2016, the AP reported. Graphic warning labels with color images have been mandated on cigarette packages

and advertisements since the 2009 passage of the Tobacco Control Act. The FDA will continue "to move forward on the work to support a new rulemaking," according to an FDA spokesman. The spokesman also said the FDA will comply with the judge's timeline, according to the AP.

Autoimmune arthritis: Types, symptoms, and treatment Autoimmune arthritis is the name given to a group of arthritis types where a person's immune system attacks itself. The most common example is rheumatoid arthritis. When the immune system attacks itself, the result is inflammation in a joint that can cause pain, stiffness, and mobility problems. There are over 100 types of

arthritis, and differ ent types cause different symptoms. Rheumatoid arthritis (RA) and psoriatic arthritis are among the most common types of autoimmune arthritis. This article will take a close look at autoimmune arthritis, identify common symptoms, and outline some of the most common treatments currently

available to combat arthritisrelated joint inflammation. Types of autoimmune arthritis Rheumatoid arthritis  Psoriatic arthritis  Reactive arthritis  Ankylosing spondyloarthritis  Axial spondyloarthritis  Juvenile arthritis  Palindromic rheumatism

Each of these conditions can cause a great deal of discomfort and swelling in the joints...Read More on the ….  Symptoms of autoimmune arthritis  Risk factors  Diagnosis  Treatment

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Study: Excessive Daytime Sleepiness May Contribute to Alzheimer’s Disease People who experience excessive drowsiness during the day were almost three times as likely to have a brain marker for Alzheimer's disease. According to a study published in the journal Sleep, adults who reported excessive daytime sleepiness during the day were 2.75 times more likely to have betaamyloid deposits on their brain about 16 years later. Betaamyloid deposits are a trademark sign of Alzheimer's. Adults who reported napping during the day were also slightly more likely to have betaamyloid deposits on their brain. Researchers studied 124 adults aged 36 to 82 who were involved in the Baltimore Longitudinal Study of Aging

Neuroimaging Substudy who reported being excessively drowsy or taking naps throughout the day, and who underwent brain scans. The study began in 1958, with participants periodically filling out surveys about their sleeping habits. Brain imaging of the participants began in 1994. The results of the study suggest that disturbed sleep and lack of sleep can be a risk factor for Alzheimer's disease in otherwise "cognitively normal adults." The study states that poor sleep quality is common among older adults and can stem from mental disorders, medication interactions or side effects, or certain medical conditions.

Adam Spira, lead author and associate professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health, told Science Daily that factors like diet and exercise have "been widely recognized as important potential targets for Alzheimer's disease prevention." However, "sleep hasn't quite risen to that status." "If disturbed sleep contributes to Alzheimer's disease we may be able to treat patients with sleep issues to avoid these negative outcomes," Spira said. The study could not conclusively state why daytime sleepiness leads to beta-amyloid deposits on the brain, but it gave several possible explanations.

The first is that disturbed sleep leads to excessive daytime sleepiness, which leads to the deposits. Second, excessive daytime sleepiness results directly from beta-amyloid deposits. Third, excessive daytime sleepiness promotes beta-amyloid aggregation. And fourth, changes in the body's natural circadian rhythm influences sleeping patterns and beta-amyloid deposits. "There is no cure yet for Alzheimer's disease, so we have to do our best to prevent it. Even if a cure is developed, prevention strategies should be emphasized," Spira said. "Prioritizing sleep may be one way to help prevent or perhaps slow this condition."

Apathy Might Be a Warning Sign for Dementia If you notice ongoing apathy in a loved one, get it checked out. Through no fault of their own, people who were once motivated, purposeful and caring may develop deep apathy that affects every aspect of their personality. They show less and less interest in favorite activities, work obligations, household tasks, punctuality, personal appearance or other people's feelings. Older and even middle-aged

adults can become uncharacteristically blasé as a forerunner to dementia, years before clear-cut signs appear. See what experts are learning about the apathy-dementia connection, and how family members try to cope in this difficult situation. Diane Keller was frustrated. In 2011, Diane, a retired college consultant in Alameda County, California, and her husband Kevin, who had previously

worked in the computer field, were selling their house to downsize. "I couldn't get him to do any of the tasks, like taking stuff to Goodwill, cleaning the pool or anything," she says. Normally, Kevin, who was 63 at the time, would have pitched right in. "He was a very busy guy and kind of a Mr. Fix It guy," she says. "He basically would clean the garage with a toothbrush." Her husband had

planted 150 vines in the backyard, which he carefully tended so the couple could make wine. But she noticed a change. "Why isn't he cutting the vines?" she recalls thinking. "Why isn't he tending to his man cave in the garage?" Always punctual in the past, Kevin started showing up late for everything. "He really couldn't care less if he was inconveniencing someone," she says….Read More

What Factors Make for the Best Assisted Living Facilities? If you were born between 1946 and 1964, you count yourself, of course, as part of the baby boomer generation that is the largest in American history. And boomers age just like everyone else. In March 2018, the U.S. Census Bureau reported that by 2035, adults aged 65 and older will number more than 78 million. By comparison, kids aged 18 and younger are expected to total just 76.4 million, meaning that in short order, the number of seniors in

the country will outnumber children for the first time in American history. As they continue to age, many people need some help in completing the daily tasks of living. Faced with the decision of how to address these needs, thousands are settling on the option of an assisted living facility. Definitions of assisted living can vary from state to state and facility to facility, but

"we generally define it as another long-term care option for folks that generally don't need 24/7 skilled nursing care, which is what most long-term nursing homes provide," says Rachel Reeves, director of communications for the National Center for Assisted Living, a non-profit organization representing about 4,000 assisted living facilities across the country. For many people, assisted living means they need

help with some aspects of daily living, such bathing, dressing, toileting, eating or transferring to bed at night. "Assisted living really focuses on supporting individuals with those activities, but then also maximizing independence and socialization in a home-like environment," Reeves says. Currently, the NCAL reports that there are more than 835,000 Americans residing in assisted living facilities….Read More

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Dementia: 10-year risk estimates may inform prevention A large study provides 10year absolute estimates for dementia risk. The scientists hope that by identifying people at high risk, specialists might be able to put in place early strategies for prevention. According to the World Health Organization (WHO), every 3 seconds a new case of dementia is diagnosed. It is characterized by cognitive impairment, such as having trouble recalling memories, solving problems, and reasoning logically. Some of the main dementia risk factors include

aging, stroke, and high blood pressure. Recent studies have also found that biological sex and a particular variation in the APOE gene — the e4 allele — both affect a person's overall risk. The APOE gene encodes apolipoprotein E, a protein that plays a vital role in regulating cholesterollevels, and which may also be key in reducing the levels of the protein beta-amyloid, which can form toxic plaques in the brain.

A team at the Copenhagen University Hospital in Denmark believes that if we can identify people at the highest risk for dementia early on and understand what places them at such a high risk, we may also be able to implement appropriate preventive measures. The researchers conducted a large population study in order to calculate the 10-year absolute risk estimates for dementia based on age, sex, and the existence of the e4 allele of the APOE gene.

Study co-author Prof. Ruth Frikke-Schmidt and colleagues published their results in the Canadian Medical Association Journal. The three factors that determine high risk The researchers analyzed the medical data of 104,537 people from Copenhagen in Denmark. They obtained this information through the Copenhagen General Population Study (conducted in 2003– 2014) and the Copenhagen City Heart Study (1991–1994 and 2001–2003)….Read More

Evidence Doesn't Support Statin Use in Healthy Seniors There is no evidence to support the widespread use of cholesterol-lowering statin drugs to prevent heart disease and stroke in old and very old people, Spanish researchers say. For the new study, the investigators analyzed data from nearly 47,000 people aged 75 and older with no history of heart disease. Statins were not associated with a reduced risk of heart disease or death from any cause in healthy people over age 75, the study found. But among people aged 75 to 84 with type 2 diabetes, statins were linked to a 24 percent

lower risk of heart disease and a 16 percent lower risk of death from any cause. This protective effect declined after age 85 and was gone by age 90, the findings showed. The study, led by Rafel Ramos, a researcher at the University of Girona in Spain, was published online Sept. 5 in the BMJ. The results do not support the widespread use of statins in healthy old and very old people, the study authors said. But the findings do support statin treatment in those under 85 years of age with type 2

diabetes, they concluded. Aidan Ryan, an academic clinical fellow at University Hospital Southampton in the United Kingdom, and colleagues wrote an editorial that accompanied the study. The editorialists noted that these observational findings need to be confirmed in randomized trials. Until then, "patient preference remains the guiding principle while we wait for better evidence," Ryan and colleagues concluded. Heart disease is the leading cause of death worldwide,

especially among people 75 and older. Statin prescriptions to elderly patients have increased in recent decades, and clinical trial evidence supports their use in people 75 and older with existing heart disease, the study authors pointed out in a journal news release. But there is a lack of evidence on the benefits of statins for older people without heart disease, especially those aged 85 and older, as well as those with diabetes, the researchers said. More information The U.S. National Institute on Aging has more about heart health and aging.

Walking may prevent heart failure in senior women New research examines the effect of walking on two subtypes of heart failure in aging women. The findings were published in the Journal of the American College of Cardiology: Heart Failure. According to recent estimates, almost 5 millionpeople in the United States have congestive heart failure. Over half a million cases are diagnosed each year. Despite its name, "heart failure" does not mean that the

heart has stopped working completely, explain the American Heart Association (AHA). In congestive heart failure, the heart is not pumping blood as well as it should be. Heart failure occurs in two main ways: either the muscles of the heart weaken, or they become stiff and lose their elasticity. Although the condition affects people of all ages, it is more

prevalent among seniors over the age of 60. The AHA recommend that people at risk avoid smoking, exercise more, and eat heart-healthy foods. A new study delves deeper into one of these potential strategies for prevention. Researchers from the University of Buffalo in New York set out to investigate how walking affects two heart failure subtypes: reduced ejection fraction heart failure, and

preserved ejection fraction heart failure. Michael LaMonte, a research associate professor of epidemiology at the University of Buffalo School of Public Health and Health Professions, led the study. Studying walking and heart failure in women Reduced ejection fraction heart failure occurs when the heart's left side pumps less blood into the body than normal. ..Read More

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RI ARA September 16, 2018 E-Newsletter  

RI ARA September 16, 2018 E-Newsletter  

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